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Why is my eyelid twitching?

Ocular Myokymia is a condition that is a common cause of eyelid twitching. It results in the spasm of the ,muscle around the eye called the Orbicularis Oculi..This is usually harmless and does not lead to other problems and it is can be caused by being tired having too much caffeine or stress. If it is persistent and frequent and bilateral which means occurring on both sides, then it can be known as essential blepharospasm.


What is eye twitching?


An involuntary or abnormal blinking of your eyelid is known as an eye twitch. Eye lid abnormal blinking may happen many times a day. If it's severe, it can affect your vision, by creating difficulty in you opening your eyes. There is one muscle of the face that closes the eyelid and another one that raises the eyelid problems with either of these muscles and sometimes both of them can cause eyelids to twitch. Other muscles may also contribute to this. Many people may have an occasional twitch and this is normal, particularly if you are tired or have had a lot of a lot of caffeine. Frequent twitching of the eyelids is uncommon and anyone that has an eye twitch that is happening more than more frequently should seek medical advice


What causes eye twitching?


Ocular Myokymia is the medical name for eye twitching that occurs on one side. This is benign, which is harmless and does not lead to other problems. Persistent or frequent twitching on both sides of the face is known as essential blepharospasm. There is not an exact answer as to what causes it, but it can cause problems with the muscle groups around the eye. It is suggested that problems with part of the brain known as the basal ganglia may play a role and that certain genes in your DNA may also contribute to it. Rarely, other problems of the brain and nervous system can cause eyelid twitching. These include Parkinson's disease, brain damage from inflammation or from a stroke. reaction to medication particularly those used in mental health illnesses, a syndrome known as Meig’s syndrome, multiple sclerosis, hemifacial spasm and Bell's palsy.

Who is at risk of eye twitching?


If you have a history of head injury, this may increase your risk of eye twitching. You may also have a greater risk of developing the condition if other family members of your family have eye twitching or you have used certain medical that is known to cause an eyelid twitch.


What are the symptoms of eye twitching?


The twitches of the eyelid can vary from being very mild to being quite severe in frequency. Some people can have twitching every few seconds and other people can have them far less commonly. It can last for days or longer and it may go and then come back, giving you periods of respite. In some people the eyelid twitching happens far more often lasts for prolonged periods of time. In other people it often goes away and never comes back. Twitches tend to be found in the upper eyelid more commonly. In addition to the twitching, you may also notice:

  • Irritation of the eye.

  • An increased rate of blinking sensitivity to light

  • Vision problems if the frequency of the twitch is high

  • Dry eyes

  • Facial spasm

These symptoms of the twitch may go away when you are asleep or concentrating intently. Other things that make the symptoms increase contend to be tiredness, bright lights, caffeine, driving stress, or irritation from the eye from another cause.


How is eye twitching diagnosed?


When you see your ophthalmologist or oculoplastic surgeon, they will take a detailed history and also perform a physical examination of your eyes. This may include a nervous examination. If they cannot find any other cause for your eyelid twitching, it may you may be diagnosed with Ocular myokymia, benign essential blepharospasm or hemifacial spasm. Usually you do not need other tests, but sometimes they may order some imaging such as the MRI of the brain to rule out other medical causes or adjustment of medication that results in the twitch.


How is eye twitching treated?


If your condition is not severe and does not impact your quality of life, it often may need no treatment at all. You may be focused on just getting more rest and reducing your caffeine intake to try and reduce your symptoms. If it is causing you problems however, it might be recommended to have botulinum toxin injections into the muscles of your eyelids. This will paralyse the muscle that is twitching.


If your eyelid twitching is very severe, you may have you may be considered for surgery called myectomy. This is to remove some of the muscles and nerves within the eyelid to stop the symptoms or at least reduce them significantly. Your doctor may refer you to a neurologist to treat any other conditions that may be associated with eyelid twitching such as Parkinson's disease.


What are the possible complications of eyelid twitching?


If the twitching is severe, and long term, then it can permanently permanently damage your eyelids and other structures in the eye. This can cause:

  • Upper eyelid ptosis

  • The eyebrows are resting lower than normal

  • Blepharochalasis which is extra skin of the upper or lower eyelid

  • An abnormal folding of the skin in the eyelids.

People with chronic eyelid twitching can also develop muscle spasms in other parts of the body such as the jaw or the neck.


How to manage eyelid twitching?


If your condition is mild, you can take some simple steps to try and reduce the twitch. This includes avoiding caffeine, ensuring you get enough sleep at night, reducing your levels of stress.

Treating any other cause of eyelid of eye irritation and using dry eye drops and the use of sunglasses in bright light.

When should I call my ophthalmologist?


You should call your ophthalmologist if your twitching is lasting for longer than one week. Or if you have any new or additional symptoms such as facial swelling or discharge from your eye.

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